[Fit for work judgment and ionizing radiation: discussion of clinical cases]. / Giudizio di idoneità e radiazioni ionizzanti: discussione di casi clinici.

SUMMARY: Introduction. The formulation of the suitability for risk assessment from exposure to ionizing radiation in workers diagnosed with malignant tumor disease entails important implications of a professional, human, social, but also medical-legal, nature. By now, the management of such situations is an event anything but infrequent in the activity of the Authorized Physician: the increase in the number of people staying in wore and the rise in the incidence and prevalence of malignant neoplastic diseases in the working-age population make the problem more relevant than ever. This is not only because of the improvement of the diagnostic and treatment capacity but also for the increased survival that follows from them. The result is therefore an increase in the cases that can potentially reach the antention of the Authorized Physician/Competent Physician who - in compliance with the provisions of current legislation - will be thus called to express the suitability assessment for the specific task by applying criteria that respect the highest and current scientific evidence in this field. Materials and Methods. Through the guided illustration of two clinical cases, it is intended to propose here a - practical and reasoned - path towards the formulation of the assessment on the occupational reintegration of the worker with diagnosis of neoplastic disease. This methodology is applied and developed through the systematic recourse to objective and specific orientation criteria, able to guide the decision-making process of the Authorized Doctor/Competent Doctor. Results. The proposed criteria were applied to workers operating in the healthcare sector and assigned to different types of activities who were at risk from exposure to ionizing sources. Conclusions. The proposed evaluation path is intended to represent a clinical and rational methodology of approach and management to the problem of assessing the suitability of workers with previous neoplastic diseases, all that by fully safeguarding the decision-making autonomy - variable from case to case - which is characteristic of the activity of the Authorized Physician/Competent Physician.

[Cell Phones, Radio Frequencies (RF) and Health: IARC classification and epidemiological updates]. / Cellulari, Radiofrequenze (RF) e salute: classificazione IARC e aggiornamenti epidemiologici.

SUMMARY: In 2013, IARC classified the radiofrequency emitted by mobile phones exposure as possibly carcinogenic to humans (Group 2B). After this classification, several studies were carried out to confirm and to robust or to reject IARC conclusions. Aim of this work was to draw a synthesis of principal scientific evidencies published till September 2019. The analysis of published results could not indicate clear risk profiles, nor surely confirm or reject the hypothesis that exposures to radiofrequency from mobile phones can threat human health. Despite the prevalence of negative studies, some methodological and temporal limitations prevent to draw firm conclusions about the potential health risks for humans, especially for heavy exposed subjects or particular categories such as children or adolescents. Thus, further studies are needed, as well as some methodological improvements, to fully respond to the question about health threats of radiofrequency emitted by mobile phones.

[Commuting and work: health effects on an exposed occupational population]. / Pendolarismo e lavoro: effetti sulla salute di una popolazione di lavoratori interessati dal fenomeno.

OBJECTIVES: Commuting is generally described as a modern society issue; despite the relevance of this phenomenon, only few studies investigated occupational and health effects of commuting on workers exposed to it. According to the 15th census of the Italian population, in Italy about 29 millions of people (48,6% of total resident population) daily moved to reach their work. During last ten years, this number increased of about 2.1 millions of people, and also time and distances needed to reach work grew, with a potential high impact on health and environment. Thus, the aim of this study is to analyze the possible relationship between commuting and health effects on a group of workers exposed to this risk factor. METHODS: Our study analyses health effects related to commuting in an exposed occupational population, by means of the self-completed ad-hoc questionnaire provided to workers of different plants in the North of Italy. RESULTS: Our results are consistent with scientific literature ones. Commuting exposed workers showed increased risk of headache and sleep disorders. CONCLUSIONS: Our study is an explorative but structured evaluation of health effects of commuting and a base for further researches.

[Judgment of fitness for work in employees with a history of malignant neoplastic disease and exposed to ionizing radiations: evaluation criteria and their application in a case-series study]. / Il giudizio di idoneità al rischio da esposizione a radiazioni ionizzanti nei lavoratori con pregressa patologia neoplastica: criteri di valutazione e analisi di una casistica.

INTRODUCTION: The increase in working age has many epidemiological consequences, one of which is an increased incidence of neoplastic diseases among the working population. Therefore it is more frequent than in the past that the Approved Physician ("Autorizzato" according to Italian legislation) have to judge working fitness in employees suffering from cancer and at the same time exposed to ionizing sources. AIMS: In this study we give suggestions for the decision if a worker, who have previously suffered from malignant tumors, is ready to go or not to go back to work. METHODS: Though we believe in the preventive theory of the linear correlation without threshold for stochastic effects ("Linear No Threshold" LNT), we considered data from the literature that highlight how very low doses of radiation exposure do not increase the risk of stochastic effects and how the potential occupational exposure to low doses does not introduce a significant additional risk of cancer in subjects with a history of malignant tumor. RESULTS: We identify "objective" elements of judgment related to the neoplastic disease of the worker and his activity, but we emphasize the importance of the psychological condition of the worker, as well as his professional interest and his career opportunities. CONCLUSIONS: The criteria we recommend were applied to a group of workers suffering from cancer and with different working activities at risk of exposure to ionizing radiations. The evaluation process is a first rational approach to the assessment of their suitability in worker suffering from neoplastic disease, with the need for custom handling for each individual.